JENCY PAULY VATHIKULAM Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063252

License Status

EXPIRED

Business

First Name

JENCY

Middle

PAULY

Last Name

VATHIKULAM

Business Name

JENCY PAULY VATHIKULAM

Original Issue Date

06/19/2013

Effective Date

06/19/2013

Expiration Date

06/18/2016

City

BERWYN

State

Zip

60402

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

08/16/2016